Is it possible to identify COVID-19 infection-related biomarkers during pregnancy?: A prospective study in Turkish population.

The coronavirus disease 2019 (COVID-19) has raised concerns about the potential complications it may cause in pregnant women. Therefore, biomarkers that can predict the course of COVID-19 in pregnant women may be of great benefit as they would provide valuable insights into the prognosis and, thus, the management of the disease. In this context, the objective of this study is to identify the biomarkers that can predict COVID-19 progression in pregnant women, focusing on composite hemogram parameters and systemic inflammatory and spike markers. The population of this single-center prospective case-control study consisted of all consecutive pregnant women with single healthy fetuses who tested positive for COVID-19 and who were admitted to Bakirköy Dr Sadi Konuk Training and Research Hospital in Istanbul, Turkey, a COVID-19 referral hospital, between April 2020 and March 2021, with an obstetric indication, during their second or third trimester. The control group consisted of consecutive pregnant women with a single healthy fetus who were admitted to the same hospital within the same date range, had demographic and obstetric characteristics matching the patient group, but tested negative for COVID-19. The patient and control groups were compared in terms of platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), and neutrophil-to-lymphocyte ratio (NLR), and systemic inflammatory and spike markers, including C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), cluster of differentiation 26 (CD26), and B7 homolog 4 (B7H4). There were 45 (51.1%) and 43 (48.8%) pregnant women in the patient and control groups, respectively. There was no significant difference between the groups in demographic and obstetric characteristics (P > .05). The PNR, PLR, and CRP values were significantly higher in the patient group than in the control group (P < .05). On the other hand, there was no significant difference between the groups in IL-6, IL-10, CD26, and B7H4 levels (P > .05). The findings of our study showed that specific inflammatory markers, such as CRP, PLR, and PNR, can potentially predict the course of COVID-19 in pregnant women. However, more comprehensive, well-controlled studies are needed to corroborate our study's findings and investigate other potential inflammatory markers.

Can platelet indices be of value in pregnant women with malaria?

Malaria infection in pregnancy is a serious disease with feto-maternal adverse outcomes. In this study we evaluated and compared the haematologic parameters of pregnant women with and without malarial infection. This case-control study included a total of 145 participants (59 pregnant women with malaria and 86 aparasitemic pregnant women). Haematological parameters were evaluated using an automated hemo-analyser. Haemoglobin, platelet, white blood cell and platelet distribution width (PDW) of pregnant women with malaria were found to be significantly lower than pregnant without malaria. However, the mean platelet volume (MPV) of pregnant women with malaria was significantly higher than those without infection.Impact StatementWhat is already known on this subject? Malaria infection in pregnancy is a serious disease and may affect haematological parameters.What do the results of this study add? Platelet indices were significantly changed in malaria. Especially mean platelet volume (MPV) with malaria was significantly higher than those without infection.What are the implications of these findings for clinical practice and/or further research? Among the expected differences in haematologic parameters of pregnant women with malaria, the increase in MPV has been a novel finding. The increase in MPV level of pregnant with malaria should be investigated further to address the value of MPV as a prognostic factor.

The Association between the Preoperative Prognostic Nutritional Index and the Controlling Nutritional Status Score on Tumor Stage, Chemotherapeutic Response and Overall Survival in Ovarian Cancer.

This study aimed to investigate the association between preoperative prognostic nutritional index (PNI) and controlling nutritional status (CONUT) scores on the stage of ovarian cancer (OC), chemotherapeutic response, and overall survival (OS) in patients with OC.The data of the patients who operated due to OC between January 2015 and January 2020 in a tertiary referral hospital were recorded. The patients' basic characteristics, preoperative total cholesterol, albumin, lymphocyte count, tumor markers, disease stage, grade, chemotherapeutic response, OS, and progression-free survival were recorded. The PNI and the CONUT score were calculated.The mean PNI level was considerably higher in the early-stage group than the advanced-stage group (50.02 ± 6.8 vs. 46.3 ± 7.4, p = 0.005). The AUC was 63% for the cutoff point 45.98 of PNI, whereas the AUC was 42% for the cutoff point 1.5 of CONUT score in predicting early-stage disease. The PFS and OS were significantly higher in the high PNI group than the low PNI group (p = 0.01, p = 0.002, respectively).The patients with early-stage OC had significantly higher PNI levels and lower CONUT scores in our study population.

The effect of new cross linked hyaluronan gel on quality of life of patients after deep infiltrating endometriosis surgery: a randomized controlled pilot study.

In this prospective randomised placebo-controlled study, we aimed to evaluate the effect of New Cross linked Hyaluronan Gel (NCH gel) on the quality of life of patients who underwent laparoscopic surgery due to Deep Infiltrating Endometriosis (DIE). The intervention group received 40 mL of NCH gel, and the control group had a 40 mL sterile saline solution instilled into the peritoneal cavity following standard laparoscopic procedures. The patients were called in the third and sixth postoperative months and requested to fill the Visual Analogue Scale (VAS), Endometriosis Health Profile (EHP-5), and Short Form for Mental and Physical Health (SF-12) questionnaires. There was a significant reduction in dysmenorrhoea, dyschezia, dyspareunia VAS scores at 3rd, and 6th-month visits in NCH gel group. The postoperative 6th-month EHP-5 scores were significantly lower (1.16 ± 1.51, p-value: .02) in NCH gel group. Besides, NCH gel group had higher SF-12 mental and SF-12 physical scores. Clinical Trials registration number: NCT04023383IMPACT STATEMENTWhat is already known on this subject? Application of solid or liquid physical barriers is believed to be a promising strategy to reduce adhesions after laparoscopic endometriosis surgery. However, comparable data regarding the effects of adhesion barriers are still lacking.What the results of this study add? We revealed that there was a significantly higher decrease in VAS and EHP-5 scores and an increase in SF-12 physical-mental ratings after surgery in NCH gel group.What are the implications of these findings for clinical practice and/or further research? Using NHC gel in addition to standard surgical procedure improves postoperative VAS scores, and provides better quality of life scores.

Conventional Laparoscopy or Vaginally Assisted Natural Orifice Transluminal Endoscopic Surgery for Adnexal Pathologies: A Paired Sample Cross-Sectional Study.

AIM: To compare the results of conventional laparoscopic (CL) and vaginal natural orifice transluminal endoscopic surgery (vNOTES) techniques for the treatment of benign adnexal pathologies. MATERIALS AND METHODS: The study consisted of 114 patients who underwent CL or vNOTES for oophorectomy, ovarian cystectomy, or ectopic pregnancies. The medical and surgical data of the study population in terms of age, gravidity, parity, body mass index (BMI), duration of surgery, size of the mass, decrease in hemoglobin/hematocrit levels, the presence of complications, and visual analogue scale (VAS) pain scores at the 6th and 24th hours were analyzed. RESULTS: Both groups of patients (CL and vNOTES) had a similar mean age (42.22 ± 12.05 vs. 42.38 ± 13.06), mean BMI (27.51 ± 4.96 kg/m2 vs. 29.63 ± 7.86 kg/m2), and mean mass size (53.17 ± 24.41 vs. 48.93 ± 32.33) (the p-value was nonsignificant for all comparisons). According to the logistic regression propensity score match model, the duration of surgery was significantly shorter in the vNOTES group (48.33 ± 33.12 min) compared to the CL group (72.23 ± 43.63 min) (p = .04). Postoperative hospital stay was significantly shorter in the vNOTES group (38.4 ± 14.91 hours) compared to the CL group (48 ± 17.82 hours) (p = .03). Postoperative 6th- and 24th-hour VAS pain scores were significantly lower in the vNOTES group (p = .003 and .03, respectively). CONCLUSION: As an alternative to CL, vNOTES seems to be a promising approach for the treatment of a variety of adnexal pathologies.

Biomarker Modulation Study of Celecoxib for Chemoprevention in Women at Increased Risk for Breast Cancer: A Phase II Pilot Study.

In preclinical studies, celecoxib has been associated with reduced risk of breast cancer. In this study, the aim was to assess the biomodulatory effect of celecoxib on blood and benign breast tissue biomarkers in women at increased risk for breast cancer. Women at increased risk for breast cancer [5-year Gail risk score of >1.67%, history of atypical hyperplasia, lobular carcinoma in situ, or previous estrogen receptor (ER)-negative breast cancer] were treated with celecoxib at 400 mg orally twice daily for 6 months. Participants underwent random periareolar fine needle aspiration and blood draw at baseline and at 6 months for analysis of biomarkers: serum levels of insulin-like growth factor 1 (IGF-1), IGF-binding protein 1 (IGFBP-1), and IGFBP-3; tissue expression of Ki-67 and ER; as well as cytology. Forty-nine patients were eligible for analysis. Median IGFBP-1 levels increased significantly from 6.05 ng/mL at baseline to 6.93 ng/mL at 6 months (P = 0.04), and median IGFBP-3 levels decreased significantly from 3,593 ng/mL to 3,420 ng/mL (P = 0.01). We also detected favorable changes in cytology of 52% of tested sites after 6 months of celecoxib therapy. No changes in tissue Ki-67 and ER expression levels were observed. No grade 3 or 4 toxicity was recorded. Celecoxib was well tolerated and induced favorable changes in serum biomarkers as well as cytology in this pilot phase II trial. A phase IIb placebo-controlled study with celecoxib could be considered for women at increased risk for breast cancer.

Comparison of body mass index and metabolic parameters with serum vaspin levels in women with polycystic ovary syndrome.

This study showed that there is a positive correlation between serum Visceral Adipose tissue derived Serine Protease Inhibitor (VASPIN) level and polycystic ovary syndrome (PCOS). In previous studies, this relation was attributed to the generalization of higher amount of adipose tissue in patients with PCOS. However, we detected that VASPIN is significantly high in patients with PCOS regardless of BMI. Besides, the metabolic parameters such as fasting insulin, HOMA-IR, triglycerides and LDL-C levels were also increased in lean women with PCOS.

The effect of being diagnosed with human papillomavirus infection on women's sexual lives.

PROBLEM: Objective studies that use validated questionnaires are needed to evaluate the changes in the sexual functions of women diagnosed with human papillomavirus (HPV) infection. METHOD OF STUDY: The study comprised 80 sexually active women diagnosed with a high-risk HPV infection. These patients were divided into four groups as follows: group 1, HPV 16/18-positive and normal cytology; group 2, HPV 16/18-positive and abnormal cytology; group 3, non-16/18 HPV-positive and abnormal cytology; and group 4, non-16/18 HPV-positive and normal cytology. The sexual functions and anxiety statuses of the patients were assessed via the Female Sexual Function Index (FSFI) and Beck anxiety inventory (BAI) questionnaires, respectively, at their first clinical visits and then 2 months later. RESULTS: There was no statistically significant difference among the study groups in terms of the overall FSFI and domain sub-scores at either of the visits. Women who tested positive for the high-risk HPV 16/18 strains had a significantly less sexual desire after being informed about the test results. Those with HPV 16/18 and normal cytology had significantly higher anxiety levels at their second than first visits. The BAI scores of the HPV 16/18-positive women (normal or abnormal cytology) at the second visit were significantly higher than those of non-16/18 HPV-positive women with normal cytology. There was no significant difference between the patients with normal and abnormal cytology results regarding the difference of BAI, overall and domain FSFI sub-scores at the first and second visits. The desire and lubrication domain scores of the HPV 16/18-positive patients significantly decreased after the first visit compared with those of the non-16/18 HPV-positive patients. CONCLUSION: HPV 16/18 positivity decreases women's total FSFI and desire domain sub-scores.

Guideline for Antimicrobial Prophylaxis in Breast Surgery.

The American Society of Health-System Pharmacists (ASHP) published the 2012/2013 edition of the book entitled "Best Practices for Hospital & Health-System Pharmacy: Position and Guidance Documents of ASHP" with Bruce Hawkins as the editor. (ISSN: 15558975). Pages 582-667 of this book contain the section: "Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery". This section includes current clinical developments, evidence and recommendations on the application of standard and effective antimicrobial prophylaxis in adult and pediatric patients, and has significant differences compared to the previous 1999 edition. On pages 632-633, antimicrobial prophylaxis in breast and plastic surgery practice is addressed in detail. This article contains a summary of the recommendations made in ASHP 2012/2013 Report regarding the antimicrobial prophylaxis in breast and plastic surgery applications.